There are relatively few effective clinical options for preserving female fertility, particularly following aggressive chemotherapy and or radiotherapy treatment protocols. This paper reviews the scientific background, current technology, clinical results and potential future applications of two methods of preserving female fertility-ovarian tissue cryopreservation and oocyte cryopreservation. These technologies are investigational, although rapidly evolving and their list of appropriate indications may be expanded in the future.
CRYOPRESERVATION ; FERTILITY AGENTS, FEMALE

Antiviral Agents ; therapeutic use ; Female ; Fertility ; Hepatitis B ; drug therapy ; Hepatitis B virus ; Humans

The present experiment aims to examine the efficiency of estrus synchronization using progesterone and equine chorionic gonadotrophin (eCG) and to look at luteal function. During the non-breeding and breeding season, 5 adult female Korean native goats were injected intramuscularly with 2.5 ml of physiological saline as the control. A progesterone impregnated intravaginal sponge was then kept in the same goats for 10 days followed, after a week, by an intramuscular injection of 500 IU eCG. Five adult female Nubian goats were mated with a fertile buck during the non-breeding season. During the non-breeding season 2 of the 5 goats showed a normal estrous cycle (ranging from 18 to 21 days) and 3 a short estrous cycle (ranging from 3 to 6 days). During the breeding season the equivalent figures were 1 and 2. The major axes of the corpus luteum (CL) were measured by means of calipers built into the ultrasonography system, and the concentrations of plasma progesterone (P(4)) were determined by double antibody radioimmunoassay. The mean major axes of the CL in goats showing the short cycle (6.1 +/- 0.5 mm) was significantly smaller than in those showing the normal cycle (8.9 +/- 0.5 mm; p < 0.01) and also the value of P4 in goats showing the short cycle (4.2 +/- 2.1 ng/ml) was significantly lower than for those showing the normal cycle (10.3 +/- 4.3 ng/ml; p < 0.05) at day 3 following ovulation. Three out of 5 Nubian goats became pregnant but only one goat carried to full term. The present experiment indicated that a combination of progesterone and eCG was effective in inducing estrus, although it resulted in a high incidence of short luteal lifespan. The low kidding rate and high incidence of embryonic loss may be due to the instability of the luteal lifespan.
Animals ; Chorionic Gonadotropin/*pharmacology ; Corpus Luteum/*drug effects/*physiology ; Estrus Synchronization/*drug effects/physiology ; Female ; Fertility/*drug effects ; Fertility Agents, Female/pharmacology ; Goats/*physiology ; Horses ; Pregnancy ; Progesterone/blood/*pharmacology

INTRODUCTIONSuperovulation-intrauterine insemination (SO-IUI) is the most common assisted reproductive technique (ART) in the world, with good evidence of efficacy and cost-effectiveness. However, parameters affecting its success have not been consistently reported. So in this study, we aim at determining the parameters influencing the success rate of SO-IUI.

MATERIALS AND METHODSWe conducted a retrospective cohort study of 797 SO-IUI cycles from 606 patients, performed between 2007 and 2009 in a single centre. These women received clomiphene citrate (CC), recombinant FSH (rFSH) or both.

RESULTSThere were 127 clinical pregnancies with a pregnancy rate (PR) of 15.9% (127/797) per treatment cycle. Factors associated with higher PR included maternal age <38 (P = 0.02), subfertility diagnoses of ovulatory disorders, unexplained infertility, sexual dysfunction and unilateral tubal obstruction (P = 0.02), an endometrial thickness ≥8 mm (P = 0.03), total number motile spermatozoa (TNMS) of ≥1 million (P = 0.03), and spermatozoa normal forms (NF) ≥4% (P <0.01) on bivariate analysis. When CC is used, the endometrial thickness is more likely to be suboptimal (<8 mm). All the above parameters remained significant except the subfertility diagnoses on multivariate analysis.

CONCLUSIONPatients' selection with women <38 years old and preferably with ovulation disorders and unexplained infertility is associated with the highest PR in SO-IUI. Cycle parameters such as the use of rFSH alone, with the avoidance of CC, TNMS ≥1 million and NF ≥4% is likely to result in the best outcomes and reduce the high order multiple pregnancy risk.

Adult ; Age Factors ; Clomiphene ; therapeutic use ; Cohort Studies ; Female ; Fertility Agents, Female ; therapeutic use ; Humans ; Infertility, Female ; etiology ; Insemination, Artificial ; methods ; Pregnancy ; Pregnancy Rate ; Prognosis ; Retrospective Studies ; Superovulation

To investigate the clinical effect of tonifying the kidney and promoting blood circulation to promote oocyte decoction in the treatment of anovulatory infertility caused by polycystic ovary syndrome. Sixty cases were selected from the out-patient department of Xiyuan hospital of China academy of Chinese medical sciences and the Chinese academy of traditional Chinese medicine, Chinese medicine out-patient department. Sixty patients with PCOS patients were randomly divided into the treatment group and the control group, with 30 cases and 30 cases respectively. The treatment group was given decoction of the reinforcing kidney, activating blood circulation and ovarian stimulation compound recipe. The control group was treated with clomiphene. Through the treatment of 1-2 courses, in the treatment group the pregnancy rate was 56.67%, the ovulation rate 61%; in control group of clomiphene citrate ovulation ratepregnancy rate was 30% , 72.84% of ovulation rate. The difference was significant between two groups (P < 0.05), the pregnancy rate in the treatment group was higher than the control group. The treatment group has regulatory effect on FSH, LH and their ratio, and increase E2 level, decrease T, PRL, INS and other hormone levels, contributing to the mature development of the follicles and endometrium growth, increase the ovulation rate and pregnancy rate. The control group on FSH, E2 increased, LH, T, PRL and INS showed no obvious effect.
Adult ; Drugs, Chinese Herbal ; pharmacology ; Female ; Fertility Agents, Female ; pharmacology ; Humans ; Infertility, Female ; drug therapy ; etiology ; Kidney ; drug effects ; Ovulation ; drug effects ; Ovulation Induction ; Polycystic Ovary Syndrome ; complications

OBJECTIVETo evaluate Ficus asperifolia (Moraceae) (F. asperifolia) effecting on regular estrus cycle of Wistar rats.

METHODSAir-dried fruits of F. asperifolia were extracted using water. Prior to the test, vaginal smear was monitored daily for a 3-week period to select females with normal (regular) estrous cycle. Those with regular estrus cycle weighing between 150-170 g were randomized into three sets of 15 animals each. Each set was then divided into three groups: Group 1 (control) was orally administered with distilled water (10 mL/kg body weight) once a day for 1 week starting from the proestrus stage. Groups 2 and 3 were respectively treated with 100 and 500 mg/kg body weight of the plant aqueous extract. The two other sets of 15 animals each were similarly treated as the first set for 3 weeks and 6 weeks respectively. Estrus cycle pattern was monitored before and during plant extract application whereas lipid profile, ovary, uterus and liver growth indices were determined at the end of each treatment.

RESULTSF. asperifolia did not disrupt (0%) the order of appearance of normal estrus cycle stages, namely, proestrus, estrus, metestrus and diestrus. Short-term treatment (1 week duration) exhibited high frequency of appearance of proestrus and estrus stages while mid- (3 weeks) and long-term (6 weeks) treatments revealed constancy in the frequency of all stages irrespective to animal groups. The plasma and organ lipid profile, as well as ovary, uterus and liver growth remained unchanged when compared to distilled water-treated animals. Following long-term administration of plant extract (6 weeks), no adverse effect was noticed.

CONCLUSIONSOur data partially support the use of F. asperifolia in common medicine.

Administration, Oral ; Animals ; Estrus ; drug effects ; Female ; Fertility Agents, Female ; pharmacology ; Ficus ; chemistry ; Plant Extracts ; chemistry ; pharmacology ; Rats ; Rats, Wistar ; Time Factors

OBJECTIVETo investigate the value of serum estradiol increment and serum estradiol/follicles on the day of hCG administration in predicting the clinical outcomes of in vitro fertilization-embryo transfer (IVF-ET).

METHODSA retrospective analysis of the IVF-ET data was conducted involving 121 patients who received a long gonadotrophin-releasing hormone agonist (GnRHa) protocol. According to the increment of serum estradiol on the day of hCG administration (relative to the level on the day before hCG administration), the patients were divided into 3 groups (A1, A2 and A3) with a increment ratio below 30%, between 30% and 50%, and over 50%, respectively. In addition, according to the ratio of serum estradiol level on hCG day to mature follicle (diameter ≥ 14 mm) number, these patients were divided into three groups (B1, B2 and B3) with the ratio below 250 pg/ml, between 250 and 350 gp/ml, and over 350 pg/ml, respectively. The hormonal characteristics and clinical outcomes of the IVF-ET cycles were analyzed comparatively.

RESULTSBoth the clinical pregnancy rate (71.05%) and embryo implantation rate (52.63%) were significantly higher in group A3 than in groups A1 and A2 (P<0.05). The best clinical pregnancy rate (67.86%) and embryo implantation rate (49.14%) were significantly higher in group B2 than in groups B1 and B3 (P<0.05).

CONCLUSIONThe variation of serum estradiol shows an important impact on the clinical outcomes of IVF-ET in patients receiving long GnRH-a protocol. Favorable outcomes can be expected with a hCG day serum estradiol increment ratio above 50% and E(2)/follicle ratio between 250 and 350 pg/ml.

Embryo Transfer ; Estradiol ; blood ; Female ; Fertility Agents, Female ; administration & dosage ; Fertilization in Vitro ; Gonadotropin-Releasing Hormone ; administration & dosage ; agonists ; Humans ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Treatment Outcome

Live twin ectopic gestations are extremely rare. There are more than 100 reported twin tubal pregnancies but less than ten have foetal cardiac motions demonstrated in both embryos. We describe an additional patient with live twin ectopic gestation. A 32-year-old woman presented with increasing left-sided abdominal pains. She had a high beta-hCG level and a significant history of subfertility with previous surgical intervention. Transvaginal ultrasonography showed viable left tubal twin ectopic pregnancy. The diagnosis was confirmed at surgery. Factors that contribute to the risk of ectopic pregnancy, diagnosis and the management of this condition are described.
Abdominal Pain ; etiology ; Adult ; Female ; Fertility Agents ; Humans ; Live Birth ; Obstetric Surgical Procedures ; Pregnancy ; Pregnancy, Tubal ; diagnostic imaging ; physiopathology ; surgery ; Reproductive Techniques, Assisted ; Risk Factors ; Twins ; Ultrasonography

AIM: To evaluate the antifertility activity of Artemisia vulgaris leaves on female Wistar rats. METHOD: The plant extract was tested for its effect on implant formation at two dose levels, 300 and 600 mg·kg⁻¹, respectively. The effective methanolic plant extract was further studied for estrogenic potency on ovariectomised immature female Wistar rats. RESULTS: The data presented in this study demonstrate the antifertility potential of Artemisia vulgaris methanolic leaf extract, which shows a strong and significant decrease in implant formation (100%), and a strong estrogenic effect resulting in a significant increase in uterine weight in immature ovariectomised rats. These observations suggest that the methanolic extract of Artemisia vulgaris leaves has strong anti-implantation activity and estrogenic activity. CONCLUSION The methanolic plant extract of A. vulgaris has antifertility activity.
Animals ; Artemisia ; Contraceptive Agents ; pharmacology ; Embryo Implantation ; drug effects ; Female ; Fertility ; drug effects ; Organ Size ; Ovariectomy ; Phytoestrogens ; pharmacology ; Plant Extracts ; pharmacology ; Plant Leaves ; Rats, Wistar ; Uterus ; drug effects

A man having severe oligospermia, due to partial maturation arrest at spermatid stage, was given low dose estrogen-testosterone combination therapy for three months. His sperm count increased enormously, following which his wife conceived and delivered a healthy baby at term.
Adult ; Anabolic Agents ; therapeutic use ; Clomiphene ; therapeutic use ; Drug Therapy, Combination ; Female ; Fertility Agents, Female ; therapeutic use ; Humans ; Male ; Mesterolone ; therapeutic use ; Oligospermia ; drug therapy ; etiology ; Pregnancy ; Pregnancy Outcome ; Sexual Maturation ; Sperm Count ; Testis ; drug effects ; pathology ; Testosterone ; therapeutic use